Co-pending U.S. application Ser. No. 12/209,586, filed Sep. 12, 2008 and incorporated herein by reference, describes procedures and devices useful for implanting a gastric banding device (e.g. lap band or Swedish lap band) using a minimally invasive technique.
In accordance with one of the disclosed implantation procedures, one or more dissection instruments is passed through single port or laparoscopic access devices and used to dissect a tunnel around the posterior side of the stomach, through the fascia/connective tissue surrounding the proximal stomach and lower esophagus. A snare is advanced through the tunnel and positioned with the shaft of the snare device extending through the tunnel and with the loop of the snare accessible from or near the anterior side of the stomach. A portion of the gastric band is passed through the open snare loop and the snare loop is closed to engage the gastric band. Tension is applied to the snare to withdraw the snare back around the posterior side of the stomach and then anteriorly in order to draw the gastric band around the posterior side of the stomach. The gastric band is closed around the stomach.
The prior application describes a combination dissection and snare device particularly beneficial for carrying out the procedure. That device is disclosed as having an elongate shaft having a pre-curved distal end and an optional dissection balloon positioned on the shaft. A monopolar RF dissection wire is positioned within the shaft and has a conductive tip or electrode extendable from the shaft when needed to electrosurgically dissect or penetrate tissue. A snare loop is also extendable from and retractable into the distal end of the shaft. That device simplifies implantation of a gastric banding device in that it allows the dissection step(s) and the step of engaging the implant to be carried out with a single device. In particular, the device is advanced into the abdominal cavity, and manipulated using RF and/or blunt dissection to form an appropriate path through the connective tissue. As the device is advanced to the posterior side of the stomach, the curvature of the device carries the distal end of the device into a more anterior position. The snare is deployed from the device. The gastric band is passed into the cavity, captured using the snare, and drawn around the posterior side of the stomach using the snare.
The present application describes an improvement to the combination dissection device and snare disclosed in the prior application.